ASPO Abstracts
A qualitative analysis and description of rectal cancer survivors" barriers and facilitators to successful bowel symptom management in the Altering Intake, Managing Symptoms (AIMS) Study
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2022
Abstract Body:
Purpose of the Study: A qualitative descriptive secondary analysis to describe and understand barriers and facilitators for successful rectal cancer survivor bowel symptom management among participants in the Altering Intake, Managing Symptoms (AIMS). Methods: Participants (N=10) in the AIMS study received ten 30-minute recorded telephone coaching sessions over 18 weeks. Health coaches were trained to use Motivational Interviewing to help participants identify and overcome barriers for symptom management using dietary strategies and completed a debriefing form at the end of each coaching session. An initial inductive methodological approach was used to identify barriers and facilitators to symptom management using the coach debriefing forms. Identified themes were then organized, mapped to Social Cognitive Theory, and developed into a robust final coding scheme. Finally, one to two recorded coaching sessions per participant (n=19) were transcribed using Google Speech-to-Text and deductively coded. Results: The most frequently reported barriers to bowel symptom management were other physical symptoms affecting ability or willingness to work on goals, negative emotional/mental states such as fear around making changes , unhelpful eating behaviors such as eating a favorite food even though it is a known trigger, lack of knowledge about nutrition or diet, family/social expectations such as family members' reluctance to change eating routines, and uncontrollable life events such as holidays or appointments. The most frequently reported facilitators to bowel symptom management were family/social support, self-monitoring of food intolerances, and study-acquired symptom management-related knowledge, such as avoidance of identified foods, decreased portion sizes and changed meal timing, leading to changed eating behaviors and increased motivation and confidence. Conclusions: Bowel dysfunction is a common and persistent problem for many rectal cancer survivors. Examples from the participants' own words illustrate key barriers and facilitators that impacted their ability to successfully manage bowel symptoms. Future studies should reduce identified barriers and incorporate facilitators to improve bowel symptom management for rectal cancer survivors.
Keywords: Qualitative, Rectal Cancer, Bowel Symptoms